血清尿酸水平与急性脑梗死病情严重程度的相关性分析

目的探讨急性脑梗死病情严重程度与血清尿酸(UA)水平的相关性。方法患者入院当天按美国国立卫生院卒中量表(NIHSS)评分将126例急性脑梗死患者分成2组:NIHSS评分0～4分组50例、5～15分组76例,与50例健康对照组进行对照,测定血清UA水平,用等级相关分析来检验急性脑梗死的病情严重程度与血清UA水平的相关性。结果急性脑梗死组血清UA高于对照组(P<0.01),NIHSS评分5～15分组血清UA高于NIHSS评分0～4分组(P<0.05)。结论血清UA水平与急性脑梗死病情严重程度存在正相关。     

急性脑梗死患者血清MCP-1的测定和临床研究

目的 研究急性脑梗死患者血清单核细胞趋化蛋白-1(MCP-1)的水平及意义.方法 选取南方医科大学南方医院院神经内科自2007年4月至2007年9月收治的101例急性脑梗死患者,按美国国立卫生研究院卒中量表(NIHSS)评分分为NIHSS>5分组和NIHSS≤5分组.以同期40例健康体检者做为对照.入院时采用ELISA法检测患者血清MCP-1水平并分析其与NIHSS评分的相关性:随访患者半年死亡和缺血性血管疾病新发情况并分析MCP-1水平对生存预后的影响.结果 急性脑梗死患者血清MCP-1水平明显高于对照组,NIHSS>5组患者血清MCP-1水平显著高于NIHSS≤5组,差异均有统计学意义(P<0.05).急性脑梗死患者MCP-1水平与NIHSS评分呈正相关关系(r=0.244,P=0.014);随访结果显示血清MCP-1≤133.90 pg/mL患者预后好于MCP-1>133.90pg/mL患者,差异有统计学意K(P<0.05).结论 急性脑梗死患者血清MCP-1水平升高,并与病情严重程度相关.MCP-1水平对急性脑梗死患者发病半年内的预后有一定提示意义.     

血清TGF-β1水平与急性脑梗死侧支循环及预后相关性分析

目的探讨血清转化生长因子β1(TGF-β1)水平与急性脑梗死侧支循环形成及预后之间的关系。方法选择2016-01—2017-04于郑大五附院神经内科住院的大脑中动脉狭窄或闭塞的急性脑梗死患者96例,根据TCD检测侧支循环代偿情况分为侧支循环开放组及侧支循环未开放组,分别抽取2组发病第1天、10天、90天的静脉血标本,同时设立健康对照组50例,留取静脉血标本,ELISA法检测血清TGF-β1水平,对比分析侧支循环开放组及侧支循环未开放组患者的NIHSS评分及mRS评分。结果 (1)侧支循环开放组血清TGF-β1水平较侧支循环未开放组高,差异有统计学意义(P0.05);脑梗死急性期血清TGF-1较健康对照组下降,差异有统计学意义(P0.05)。(2)侧支循环开放组NIHSS评分明显低于侧支循环未开放组,差异具有统计学意义(P0.05);发病90d时mRS评分比较,侧支循环开放组mRS评分≤2分比例明显多于侧支循环未开放组,差异有统计学意义(P0.05)。结论血清TGF-β1水平与急性脑梗死患者侧支循环形成及预后有一定相关性。     

血清基质蛋白酶9白介素18在急性脑梗死患者的表达及与预后的关系

目的探讨血清基质蛋白酶9(MMP-9)及白介素18(IL-18)在急性脑梗死患者的表达及与预后的关系。方法选择126例急性脑梗死患者为研究对象(观察组),选择同期体检的80例健康者为对照组。比较2组患者血清MMP-9、IL-18水平及与观察组患者病情严重程度的关系。结果观察组血清MMP-9及IL-18水平显著高于对照组(P<0.05);观察组轻型、中型及重型患者血清MMP-9及IL-18水平依次升高(P<0.05);Logistic回归分析结果显示,MMP-9及IL-18水平与脑梗死患者NIHSS评分显著相关(P<0.05)。结论急性脑梗死血清MMP-9及IL-18水平显著升高,且与患者病情严重程度相关,提示炎症反应在急性脑梗死发病机制中发挥重要作用。     

血清血管生成素1水平与急性脑梗死发病、病情严重程度及90 d预后的关系

目的探讨血清血管生成素1(Ang-1)水平与急性脑梗死发病、病情严重程度及90 d预后的关系。方法对132例急性脑梗死患者(病例组)及108名健康体检者(对照组)进行血清Ang-1水平检测,同时采集相关的临床资料。病例组入院时进行NIHSS评分,将NIHSS评分5分者定义为病情轻度组,5~15分为病情中度组,≥16分为病情重度组。病例组90 d后随访行mRS评分,将mRS评分≤2分者定义为预后良好组,2分者定义为预后不良组。结果病例组吸烟史、高血压病、糖尿病、心房纤颤的比例明显高于对照组,血清Ang-1水平明显低于对照组(均P0.05)。Logistic回归分析显示,糖尿病及血清Ang-1水平均与急性脑梗死的发病密切相关(均P0.01)。病情轻度组患者血清Ang-1水平[(1.12±0.35)ng/ml]与病情中度组[(0.96±0.39)ng/ml]、病情重度组[(0.76±0.49)ng/ml]比较,差异有统计学意义(P=0.003)。进一步分析显示,急性脑梗死患者病情严重程度与血清Ang-1水平呈负相关(r=-0.267,P=0.002)。预后不良组患者的入院时NIHSS评分、高血压病、糖尿病、心房纤颤的比例均明显高于预后良好组,而血清Ang-1水平明显低于预后良好组显著降低(均P0.05)。Logistic回归分析显示,入院时NIHSS评分及血清Ang-1水平均与急性脑梗死患者90 d预后密切相关(均P0.01)。结论急性脑梗死患者的血清Ang-1水平较低,且血清Ang-1水平与急性脑梗死的发病、病情严重程度及90 d预后均密切相关。     

丁苯酞对急性脑梗死患者血清NSE S-100β及氧化标记物的影响

目的观察丁苯酞注射液对急性脑梗死患者神经功能、预后及血清神经元特异性烯醇化酶(NSE)、S-100β蛋白、丙二醛(MDA)和超氧化物歧化酶(SOD)的影响。方法将60例急性脑梗死患者随机分为丁苯酞组和对照组各30例。2组均给予常规治疗,丁苯酞组在此基础上给予丁苯酞注射液静滴,2次/d。于治疗前、治疗后7d和14d检测2组患者血清NSE、S-100β、MDA和SOD的水平变化,并比较2组治疗前后美国国立卫生研究院卒中量表评分(NIHSS)和2组3个月后改良Rankin量表(modified Rankin Scale,mRS)评分变化。结果丁苯酞组在治疗后7d和14d,血清NSE、S-100β和MDA水平均较对照组明显降低(P0.05),血清SOD水平较对照组明显升高。丁苯酞组在治疗后7d和14d,NIHSS评分较对照组明显降低,差异有统计学意义(P0.05);3个月后,丁苯酞组mRS评分较对照组明显降低,差异有统计学意义(P0.05)。结论丁苯酞注射液可降低急性脑梗死患者血清NSE、S-100β和MDA水平,提高血清SOD水平,有助于神经功能恢复,改善患者预后。     

血浆和肽素水平对急性脑梗死患者预后的评估价值

目的 探讨血浆和肽素水平对急性脑梗死患者预后的评估价值.方法 对60例急性脑梗死患者(急性脑梗死组)和60例健康体检者(正常对照组)进行血浆和肽素水平检测;并对急性脑梗死患者进行血压、血糖、血清超敏C反应蛋白(hs-CRP)水平检测,应用美国国立卫生研究院卒中量表(NIHSS)进行评分,应用MRI测量脑梗死体积,3个月后采用改良的Rankin量表(mRS)评分评价预后;分析血浆和肽素水平对急性脑梗死患者预后的影响.结果 急性脑梗死组血浆和肽素水平[( 3.73±0.49) ng/ml]明显高于正常对照组[ (2.85±0.24) ng/ml](P＜0.01);脑梗死预后不良亚组(42例)[(3.84±0.44) ng/ml]明显高于预后良好亚组(18例)[ (3.47±0.53) ng/ml] (P＜0.05);两亚组间年龄、血糖、血清hs-CPR水平、NIHSS评分、脑梗死体积的差异有统计学意义(P ＜0.05 ～0.01);单因素Logistic回归分析显示,血浆和肽素水平、年龄、NIHSS评分是影响急性脑梗死患者预后的因素(P ＜0.05 ～0.01).ROC分析显示,影响急性脑梗死患者预后的因素中,血浆和肽素水平与年龄、hs-CRP水平、脑梗死体积、NIHSS评分间差异无统计学意义.结论血浆和肽素水平升高是预测急性脑梗死患者预后不良的因素之一.     

依达拉奉联合丁苯酞对急性脑梗死患者的预后影响

目的探讨依达拉奉联合丁苯酞对急性脑梗死患者血清氨基末端脑钠肽前体(NT-proBNP)、C反应蛋白(CRP)水平变化及预后的影响。方法选择商丘市中心医院96例急性脑梗死患者,建档顺序分为治疗组和对照组各48例。2组均予以常规治疗,于此基础上对照组仅采取依达拉奉治疗,观察组联合丁苯酞治疗,均持续治疗2周。统计对比2组治疗前、治疗2周后神经功能缺损评分(NIHSS)、日常生活能力评分(BI),检测2组治疗前、治疗2周后血清NT-proBNP、CRP水平,观察2组临床疗效和不良反应发生情况。结果 2组治疗前NIHSS评分、BI评分及血清NT-proBNP、CRP水平比较,差异均无统计学意义(P0.05);治疗2周后观察组BI评分较对照组升高,NIHSS评分及血清NT-proBNP、CRP水平较对照组下降,差异均有统计学意义(P0.05);观察组总有效率为89.58%(43/48)高于对照组70.83%(34/48),差异有统计学意义(P0.05);观察组不良反应发生率6.25%(3/48)与对照组4.17%(2/48)相比,差异无统计学意义(P0.05)。结论急性脑梗死患者联合应用依达拉奉与丁苯酞治疗效果显著,可有效降低患者血清氨基末端脑钠肽前体、C反应蛋白水平,提高其日常生活能力,且安全性较高。     

急性脑梗死患者血清Apelin-13水平与神经功能损害程度及预后的相关性分析

目的 探讨急性脑梗死患者血清Apelin-13水平与神经功能损害程度及预后的相关性。方法 2019年1月-2022年3月在本院收治的急性脑梗死患者266例作为急性脑梗死组,根据美国国立卫生研究院神经功能缺损量表评分(National institute of health stroke scale, NIHSS)将其分为轻症组(NIHSS<8分,n=182)、重症组(NIHSS≥8分,n=84);同期在本院进行体检的健康志愿者200例作为正常对照组;比较急性脑梗死组、正常对照组的血清Apelin-13水平差异;比较不同病情严重程度急性脑梗死患者的血清指标水平;采用Pearson法分析血清Apelin-13水平与病情严重程度相关指标水平的相关性;根据出院3个月后改良Rankin量表(Modified Rankin scale, mRS)评分将所有急性脑梗死患者分为预后不良组(n=58)、预后良好组(n=208),分析预后不良的危险因素;采用受试者工作特征(Receiver operating characteristic, ROC)曲线分析血清Apelin-13水平对急性脑梗死患者...     

S-100β蛋白和神经元特异性烯醇化酶在急性脑梗死中的检测意义

目的 探讨S-100β蛋白和神经元特异性烯醇化酶在急性脑梗死中的检测意义.方法 选择我院2009-04-2011-04急性脑梗死患者100例作为观察组,其中轻型31例,中型42例,重型27例;腔隙性梗死30例,小面积梗死45例,大面积梗死25例.选择同期我院体检健康者50例作为对照组.检测观察组和对照组S-100β蛋白和神经元特异性烯醇化酶水平.结果 观察组S-100β蛋白和神经元特异性烯醇化酶水平显著高于对照组,差异有统计学意义(P<0.05);随着脑梗死面积增加,S-100β蛋白和神经元特异性烯醇化酶水平显著升高,差异有统计学意义(P<0.05);随着病情严重程度增加,S-100β蛋白和神经元特异性烯醇化酶水平显著升高,差异有统计学意义(P<0.05).结论 S-100β蛋白和神经元特异性烯醇化酶联合检测有助于了解急性脑梗死患者梗死面积大小及判断病情严重程度,为临床诊断和治疗提高参考.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Presence and severity of anorexia and bulimia among male and female Omani and non-Omani adolescents

OBJECTIVE: The population of Oman is a heterogeneous mix of nationalities providing a natural setting for studying the cross-cultural differences in the presence and severity of eating disorders as well as an opportunity for evaluating the performance of measurement instruments for these disorders. METHOD: Disordered eating screening instruments (the Eating Attitude Test and the Bulimic Investigatory Test) were administered to Omani teenagers, non-Omani teenagers, and Omani adults. RESULTS: On the Eating Attitude Test, 33% of Omani teenagers (29.4% females and 36.4% males) and 9% of non-Omani teenagers (7.5% of males and 10.6% females) showed a propensity for anorexic-like behavior. On the Bulimic Investigatory Test, 12.3% of Omani teenagers showed a propensity for binge eating or bulimia (13.7% females and 10.9% males). Among the non-Omani teenagers, 18.4% showed a tendency toward bulimia, with females showing a slightly greater tendency than males. In contrast, barely 2% of Omani adults showed either a presence of or a severity of disorderly behavior with food. CONCLUSION: Omani teenagers scored significantly higher than other ethnic groups and Omani adults. This finding is discussed in the light of emerging evidence from many parts of the world suggesting that cultural transition, compounded by demographic constraints, plays a significant role in abnormal eating attitudes.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

Abstract

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Micro-affirmations and Recovery for Persons with Mental Health and Alcohol and Drug Problems: User and Professional Experience-Based Practice and Knowledge

Recurrent factors contributing to a recovery process from co-occurring mental health and addiction problems mentioned by users and professionals have been analyzed as part of working alliances and helpful relationships. Still, we lack knowledge about how helpful relationships are developed in daily practice. In this article, we focus on the concrete construction of professional helpful relationships. Forty persons in recovery and fifteen professionals were interviewed. The interviews were analyzed according to thematic analysis, resulting in three themes presented as paradoxes (1) My own decision, but with the help of others; (2) The need for structures and going beyond them; and (3) Small trivial things of great importance. Micro-affirmations have a central role in creating helpful relationships by confirming the individuals involved as more than solely users or professionals. More attention and appreciation should be paid to practices involving micro-affirmations.

     

Opiate and digitalis receptor assays distinguish between neuroexcitant and inactive organochlorines and between anesthetics and convulsants

Specific binding of [3H]naloxone to rat brain tissue in vitro was inhibited by the excitant organochlorinated insecticides (OCI), by ether (E) and octanol (OCT), and by the convulsant indoklon (IND) and its anesthetic isomer, isoindoklon (ISO). In the presence of 100 mM NaCl the inhibition of naloxone binding by E, OCT and ISO was greatly potentiated, whereas that by OCI and IND was attenuated. KCl (100 mM) was equally effective as NaCl on the action of anesthetics, but the effect of the excitant drugs was, in contrast to NaCl, unaffected by KCl. Specific binding of [3H]ouabain in the absence of Na, was depressed by anesthetics and enhanced by neuroexcitants. In the presence of NaCl, which by itself inhibits ouabain binding to brain, both anesthetics and excitants enhanced ouabain binding. DDE, a non-insecticidal analog of DDT, and the dimethyl derivative of the OCI, lindane, were inactive in the receptor assays. These observations point to a unique isolated system which responds consistently to anesthetic agents as a class and, in a different way, to neuroexcitant compounds.